Professional Documents
Culture Documents
Group 3A
Peptic Ulcers
Defined
Gastric
Duodenal
Risk Factors
Lifestyle
Smoking
Acidic drinks
Medications
H. Pylori infection
90% have this
bacterium
Passed from person to
person (fecal-oral route
or oral-oral route)
Age
Duodenal 30-50
Gastric over 60
Gender
Duodenal: are
increasing in older
women
Genetic factors
More likely if family
member has Hx
Other factors: stress
Gastric Ulcers
Pain occurs 1-2 hours after meals
Pain usually does not wake patient
Accentuated by ingestion of food
Risk for malignancy
Deep and penetrating and usually occur on
Duodenal Ulcers
Pain occurs 2-4 hours after meals
Pain wakes up patient
Pain relieved by food
Very little risk for malignancy
Diagnostic Tests
Esophagogastrodeuodenoscopy (EGD)
Endoscopic procedure
Visualizes ulcer crater
Ability to take tissue biopsy to R/O cancer and
diagnose H. pylori
Pathophysiology
production
Corticosterioids associated with an
increased incidence of PUD
Genetic factors
Hyposecretory Drugs
Proton Pump Inhibitors
Suppress acid production
Prilosec, Prevacid
H2-Receptor Antagonists
Block histamine-
stimulated gastric
secretions
Zantac, Pepcid, Axid
Antacids
Neutralizes acid and
prevents formation of
pepsin (Maalox, Mylanta)
Give 2 hours after meals
and at bedtime
Prostaglandin
Analogs
Mucosal barrier
fortifiers
Surgery
Greatly decreased in the last 20-30
obstruction
Acute bleeding
Non-responsive to medications
allows regurgitation
of alkaline duodenal
contents into the
stomach
Creates a passage
between the body of
stomach to small
intestines
Keeps acid away from
ulcerated area
secretion stimulus
Surgical
Procedure/Pyloroplasty
Pyloroplasty
Widens the pylorus
to guarantee
stomach emptying
even without vagus
nerve stimulation
Billroth I
Distal portion of
the stomach is
removed
The remainder is
anastomosed to
the duodenum
Billroth II
The lower portion
of the stomach is
removed and the
remainder is
anastomosed to
the jejunum
Postoperative Care
NG tube care and management
Monitor for post-operative complications
Post-op Complications
Bleeding
Occurs at the anastomosed
site
First 24 hours and post-op
days 4-7
Duodenal stump leak
Billroth II
Severe abdominal pain
Bile stained drainage on
dressing
Gastric retention
WILL NEED TO PUT NG TUBE
BACK IN
1303)
gastrectomies
Early-30 minutes after meals
Vertigo, tachycardia,
syncope, sweating, pallor,
palpatations
Late 90 min-3 hours after
meals
Anemia
Rapid gastric empyting
decreases absorption of iron
Malabsorption of fat
Decreased acid secretions,
decreased pancreatic
secretions, increased upper
GI mobility